Adjusted preoperative variables to predict perioperative red blood cell transfusion in coronary artery bypass grafting

Lu, Liangyuan; Che, Ji; Xie, Weixin; Cheng, Weiping; Yang, Zhanmin; Dong, Ruiqi; Huang, Jiapeng; Lu, Jiakai

doi:10.1007/s11748-020-01386-3

Cited by 3 publications

(1 citation statement)

References 31 publications

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“…This can be explained by the following reasons: Aortic surgery poses a high risk due to factors like coagulation dysfunction, prolonged CPB time, and significant blood loss. 16,17 Most patients undergoing CABG have a history of coronary heart disease and hyperlipidemia, which are specific risk factors for blood transfusion 17,18 ; and they usually have more than one bridge vessels, more stomas contribute to high probability of bleeding, so the risk of blood transfusion in patients undergoing CABG is also high. However, patients undergoing valve surgery have more circulating blood volume due to valvular stenosis or insufficiency, intraoperative ultrafiltration helps to reduce the risk of blood transfusion.…”

Section: Discussionmentioning

confidence: 99%

A transfusion risk stratification score to facilitate quality management in cardiopulmonary bypass

et al. 2023

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BackgroundOur previous showed that a blood management program in the cardiopulmonary bypass (CPB) department, reduced red blood cell (RBC) transfusion and complications, but assessing transfusion practice solely based on transfusion rates was insufficient. This study aimed to design a risk stratification score to predict perioperative RBC transfusion to guide targeted measures for on‐pump cardiac surgery patients.Study Design and MethodsWe analyzed data from 42,435 adult cardiac patients. Eight predictors were entered into the final model including age, sex, anemia, New York Heart Association classification, body surface area, cardiac surgery history, emergency surgery, and surgery type. We then simplified the score to an integer‐based system. The area under the receiver operating characteristic curve (AUC), Hosmer–Lemeshow goodness‐of‐fit test, and a calibration curve were used for its performance test. The score was compared to existing scores.ResultsThe final score included eight predictors. The AUC for the model was 0.77 (95% CI, 0.76–0.77) and 0.77 (95% CI, 0.76–0.78) in the training and test set, respectively. The calibration curves showed a good fit. The risk score was finally grouped into low‐risk (score of 0–13 points), medium‐risk (14–19 points), and high‐risk (more than 19 points). The score had better predictive power compared to the other two existing risk scores.DiscussionWe developed an effective risk stratification score with eight variables to predict perioperative RBC transfusion for on‐pump cardiac surgery. It assists perfusionists in proactively preparing blood conservation measures for high‐risk patients before surgery.

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